Evidence Based Practice Essay

The following ssion of this assignment attempts to critically appraise the venUS III randomised control trial (RTC) published in the British Medical Journal.

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

The case study chosen is about Sean which comes from chapter 7 in the Crisis Intervention Case Book. Sean is a 19 year old sophomore who is currently on disciplinary probation for getting in a fight during freshman year and breaking the other students jaw. Sean admits to drinking and also smoking marijuana since high school and occasionally on campus. Currently Sean was brought to the emergency room by a friend after passing out on the lawn at a beer party. His friend had seen that Sean vomited all over himself and would not wake up. His friend then called 911 and an ambulance came. At the emergency room Sean’s stomach was pumped and a blood

The PICO (T) format is a way to develop a clinical question that lends itself to searching for evidence. Select a common nursing practice (e.g., wound care management) in your clinical setting and formulate a PICO question. Once you have formulated your question, conduct a library search and locate one scholarly article that addresses the topic you have selected. Post your clinical question in the TD, explain the PICO(T) elements, and provide a full reference of the article you selected.

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized, double-blind, cross-over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756-015-0079-y

According to Stevens (2013), the call to develop and implement evidence-based practice (EBP) within all healthcare disciplines is fueled by legislative demands for improvement in standard medical metrics such as mortality and morbidity. However, increasing demands by the public for evidence related to the metrics and outcomes of such concepts as quality of life illustrate what may be more important to the client (Stevens, 2013). This client-directed focus has resulted in patient-centered outcomes research (PCOR) (Stevens, 2013). "The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information

Standard 1.1 outlines that the registered nurse should access and analyse the best available evidence which includes research to ensure they provides safe and quality practice (Nursing and Midwifery Board of Australia, 2016). This was absent in scenario one as a result of a fast verbal medical handover Mary to Nicole. There was no guidance as to which patient was being discussed, and no time to write down all the important medical information required about her patients (Edith Cowan University, 2016). In scenario two Mary provides more guidance to Nicole about which patient she is talking about ensuring all the necessary information is received by Nicole (Edith Cowan University, 2016). Research has proven that handover is often difficult in the health care process, and often results in information being lost, distorted or misinterpreted. Verbal handover has also been described as an incomplete process when compared to information available in patient notes and records (Drach-Zahavy & Hadid, 2015). This is demonstrated in both scenarios with Nicole being given a fast handover with no guidance about where the information she is being given is relevant to. Whilst in scenario two Mary provides prompts and gives Nicole time to write down all the necessary information she requires (Edith Cowan University, 2016).

According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as

Qualifications for best available research, consist of medical (health science) research, which reigns supreme because it most likely will yield accurate, unbiased and information, with multiple practice questions for specific patients and or patient groups. The research is large and effective in relation to prevalence, treatment, assessment, disorders and patient populations. The evidence should yield systematic

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.